Immune-Related Adverse Events From Immunotherapy: Incorporating Care Step Pathways to Improve Management Across Tumor...

Area of Science:

• Oncology
• Immunology
• Clinical Therapeutics

Background:

• Immune checkpoint inhibitors (ICIs) are crucial cancer treatments.
• Immune-related adverse events (irAEs) are common and can affect any organ.
• Managing irAEs requires different strategies than traditional chemotherapy side effects.

Purpose of the Study:

• To introduce Care Step Pathways (CSPs) for improved irAE management.
• To provide a summary of ICI therapies and potential irAEs.
• To highlight the role of advanced practice providers in managing irAEs.

Main Methods:

• Development of Care Step Pathways (CSPs) by advanced practice providers.
• CSPs integrate established guidelines with practical experience for irAE assessment, grading, and management.
• Review of specific CSPs for gastrointestinal toxicity, adrenal insufficiency, nephritis, and neuropathy.

Main Results:

• CSPs offer proactive strategies, implementation tactics, patient education, and "red flags" for irAEs.
• Emphasis on medication reconciliation and comprehensive baseline assessments, including clinical and laboratory tests.
• Detailed review of CSPs for common irAEs demonstrates their practical application.

Conclusions:

• Advanced practice providers are pivotal in collaborative oncology care, particularly in patient education and AE management.
• CSPs provide a structured approach to optimize patient health and maintain ICI therapy.
• Effective management of irAEs is essential for patient well-being and treatment continuity.